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Husky Legacy Club
Register your information below to begin membership application process. Membership is limited to former Bloomsburg University Football players and coaches.
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First Name
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Your answer
Last Name
*
Your answer
Mailing Street Address
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Your answer
Mailing City
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Your answer
Mailing State
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Your answer
Mailing Zip Code
*
Your answer
Email Address
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Your answer
Phone Number
*
Your answer
Graduation Year
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Your answer
Position(s) Played / Title / Role
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Your answer
Years Played
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Your answer
Accomplishments / Accolades
Your answer
Birthday
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DD
/
YYYY
Current Occupation
*
Your answer
Current Employer
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Your answer
If already donated, how did you submit your donation? Please use the "Other" field below to provide additional reconciliation information.
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Check (Please provide date of check & amount)
EFT to HLC Banking establishment (Please provide date of EFT & confirmation #)
Venmo (Please provide your username below)
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